The Soy Sauce Incident

Originally posted Mar 2011.

A UVA freshman gets a crash course in biochemistry.

On February 28th, University of Virginia student John Paul Boldrick was dared by members of the Zeta Psi fraternity to drink a whole bottle of soy sauce. He accepted the challenge, and was later found on the second floor of the fraternity house, foaming at the mouth and seizing. He was rushed to a nearby hospital and treated. Could drinking a bottle of a common household condiment really be so dangerous? The short answer: Absolutely.

Mr. Boldrick was suffering from hypernatremia, or an excess of sodium. Most people who experience hypernatremia do so in conjunction with a larger set of symptoms we are familiar with as dehydration. In that condition, the hypovolemic type as it is called, reintroduction of water generally resolves any problems before they become severe.

Of course, being a college student off to explore new territory, Mr. Boldrick chose the less common, hypervolemic type, in which a high-sodium fluid is introduced into the system. Generally, this only happens in resuscitation cases, when patients are often given sodium bicarbonate, or in nautical accident victims, as seawater is often ingested. Doing some quick back of the napkin calculations based on a bottle I have in my fridge, I found that if Boldrick drank what I have (Kikkoman 10 fl oz bottle), he got a whopping 18,400 mg of sodium, almost 9 times the FDA’s Daily Reference Value level.

Contracting hypernatremia from ingesting sodium is particularly tricky to treat. The fact that most hypernatremics are also dehydrated makes adding fluids fairly easy; their problem isn’t as much the excess sodium but the high concentration of it due to lack of water. This case however, would have required a more delicate touch, as much more sodium was in his system than could have been easily diluted. Doctors proceeded with caution, as rebalancing his sodium levels too quickly could have led to cerebral edema, causing seizure, brain damage, or death.

The story of Sacramento resident Jennifer Strange is similar to Boldrick’s, the Zeta pledge. In 2007 Strange was competing in a radio contest entitled “Hold Your Wee for a Wii.” In Strange’s case, however, it was an excess of water rather than sodium that caused the problem. Holding back from urinating gave Strange an acute case of water intoxication, also known as hyponatremia (in contrast to Boldrick’s hypernatremia). Lower concentrations of sodium in the blood can also be dangerous.

Four days after his hospitalization, Boldrick was released, returning to his life of fraternity partying hopefully the wiser. Strange, however, was less fortunate—she died in her home the day of the contest. The takeaway from all this? Don’t participate in stunts like these. They are far more dangerous than most people realize.